Round Autoprosthesis: Use of Adipodermaglandular Flap in T Scar Mastopexy.

[PURPOSE] This study focuses on the use of round or anatomically shaped breast autoprosthesis with different volumes prepared from the central and lower poles of the breast. The technical details and surgical outcomes for patients with varying degrees of breast ptosis are discussed.

[MATERIAL AND METHOD] This study involved 42 patients who underwent the Wise-pattern superior pedicle mastopexy procedure using the adipodermaglandular island flap technique. The research spanned from December 2017 to August 2022. The study participants had not previously undergone breast surgery, did not desire breast implants, and exhibited grade 2 and 3 breast ptosis according to the Regnault Classification. Age and preoperative breast measurements of the patients were recorded for subsequent analysis. Measurements, such as the distance from the nipple-areolar complex to the inframammary fold and the distance from the suprasternal notch to the nipple-areolar complex, were taken both before the surgery and one year after. A systematic process was followed to identify acute and subacute complications during the postoperative follow-up period.

[RESULTS] This study involved 42 patients with a mean age of 33.9 years (range: 23-49 years). These procedures were conducted between December 2017 and August 2022. The average SN-N distance before surgery measured 26.7 cm (range: 24-33 cm). One year after surgery, the average SN-N distance was 23.1 cm (range: 21.3-24.8 cm). The follow-up duration for the examined cases ranged from 12 to 18 months on average. Among the observed cases, delayed wound healing was noted in one instance, venous insufficiency of the nipple in another, and fat necrosis in a third case. The overall complication rate in the group was determined to be 7.1%.

[CONCLUSION] In our study, the detachment of dermal connections at the level of the inframammary fold (IMF) and the smooth advancement of the flap in the form of an "island flap" made a contribution to upper pole fullness. Furthermore, we hypothesize that the fusion of the medial and lateral ends of the flap will enhance tissue integration during the healing process, promoting compatibility between the autoprosthesis tissue and breast tissue. Regarding the rates of complications described, classic mastopexy techniques have exhibited similar rates in our findings.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .